Friday, 5 April 2013

Doing Diabetes Differently

‘Doing
Diabetes Differently’

We
are proud to announce that we have been awarded a £75,000 Shine
award from the Health Foundation to deliver the ‘Doing Diabetes
Differently’ project, in association with Milton Keynes Hospital
NHS Foundation Trust.

The
projecthopes
to improve patient’s commitment to their diabetes treatment
regimens by improving their mental wellbeing. It is envisaged that by
offering psychological support patients will be able to make sense of
their diabetes, fit it into their lives and will feel more empowered
to manage their diabetes effectively.

We
are one of 30 project teams from across the UK whose innovative idea
to improve the quality of healthcare is being put to the test in
2013/14.

The
innovations, selected for the Health Foundation’s Shine programme,
are testing new approaches to delivering healthcare that will either
support patients to be active partners in their own care, improve
patient safety or improve quality while reducing costs.

Background
to the project

At
more than £2 billion per annum, diabetes represents one of the
greatest, and growing, costs in healthcare, rising by 8.9% each year,
and is predicted to ‘bankrupt the NHS’ by 2035. The incidence of
mental health problems in people with diabetes is very high, and is
linked with poor dietary control and treatment adherence. This leads
to increased risk of poor health outcomes and premature mortality,
doubling the cost of treatment.

However,
despite NICE recommendations, there is a scarcity of readily
accessible, appropriate, effective psychological support for diabetes
patients throughout the UK. NHS trusts lack the finance to invest in
new services, leading to the current stalemate.

Following
a voluntary pilot of solution-focused psychotherapy, this project
seeks to introduce psychological screening questionnaires as part of
routine clinic appointments and to provide brief psychotherapeutic
interventions to aid treatment adherence as an integrated part of
medical treatment, for those who need it. It will use data from
questionnaires, blood-test results and uptake of medical services to
build a model of risk factors and evaluate which of these are
improved by brief psychotherapeutic interventions.

The
approach overcomes the funding challenge by using social enterprise
employees to deliver the service through a Social Impact Bond model.
This means that the service will receive payment in arrears, based on
results at the end of each year of provision. This will enable the
hospital to ‘save to spend’ rather than ‘spend to save’,
breaking the funding deadlock.

The
project will comprise a self-contained year-long evaluation of the
improvement in patient care and reduction in costs. However, part of
the project will be to establish the viability of outcome-based
contracting for a Social Enterprise company within a health setting.

Dr
Miriam Silver, Consultant Clinical Psychologist, who is managing the
project said, “This is a very exciting collaboration which we hope
will improve patient experience and quality of life. Our delivery
model is unique and we hope to be successful in securing on-going
funding in arrears according to the outcomes we achieve”.

Dr
Asif Ali, Consultant and lead for diabetes at Milton Keynes Hospital
said: “Milton Keynes has a growing and ageing population, and more
people are being diagnosed with diabetes. We’re excited about this
project: helping patients manage their diabetes will not only improve
patients’ quality of life, but will help the hospital save money in
the long-term due to having to treat fewer complications that can
result from it not being effectively controlled.”

Dr
Jane Jones, Assistant Director at the Health Foundation, said,
‘Innovative approaches are required to tackle the challenges that
we are facing today in healthcare. We want to encourage innovators in
the service to lead the way in thinking differently and to show how
new approaches can deliver better healthcare.

‘This
year we have chosen the 30 best innovative ideas, selected from a
large number of applicants. The project teams will have the challenge
of demonstrating the practicality of their ideas and show that they
can improve quality and reduce costs with the potential to have high
impact when scaled up across the UK. Our aim is to share and promote
the most effective innovations to the clinical and managerial leaders
of the UK healthcare system and policy-makers.’

This
latest round of the Shine programme is the largest ever run by the
Health Foundation. It has 30 project teams, selected from a high
number of quality applications from across the health service.